Abstract
Depression is a health problem that is difficult to diagnose. One way to help improve the detection of diagnosis is to use a genogram. This method enables a person to determine the prevalence of a health problem in his or her family tree. Another important framework that can be utilized for treatment and management of depression is Gordon’s Health Perception-Health Management Patterns. It is important to properly diagnose depression. It is imperative to lessen the impact of the disease. It is also important to develop and adhere to certain preventive measures for preventive purposes. However, when the diagnosis is certain patient must be advised to seek professional help.
Pathophysiology of Depression
After completing the genogram I discovered that the prevalent health problem in my family is depression. Depression can be considered as an invisible sickness because there are no symptoms that manifest in the human body. High fever, itchiness, boils, weight loss, and other tell-tale signs are symptoms of common diseases. But in the case of depression there is a need for expert diagnosis in order to be sure of the medical findings. It has to be made clear that depression has its share of symptoms; however, the symptoms may vary from one person to the next. In addition, mental health professionals may even find it difficult to provide a simple definition that can cover several types of depression. As a result this health issue can be a real burden for those suffering depression and even their loved ones. It is important to learn more about this problem in order to provide treatment to the one afflicted with this disorder.
There may be no hard and fast rule that can be used to describe depression. But one can start by learning to differentiate a regular feeling of sadness such as the heartbreaking loss of a loved one as compared to the nagging feeling of melancholy that cannot be traced to a single source. For those who suffer from depression, they must be told that normal and healthy people experience feelings of sadness. However, those diagnosed with clinical depression will find out that the feeling of sadness lasts for a longer period of time. In addition the impact of these feelings is more serious than from an ordinary type of sadness.
A more technical definition of depression can be understood through the following: “The common definition of depression includes a general sense of helplessness resulting from a self-perception of inadequacy whereby the person feels powerless to control his/her life” (McCullough, 2003, p. 19). Mccullough adds that all the information from the social environment gets processed in the brain and therefore depression is related to the mind. Researchers in the field of psychology offer another insight into this mental health issue and pointed out that depression is imminent if the person exhibits five out of nine of the following symptoms: a) low mood; 2) loss of interest or pleasure in almost all of his or her usual activities; 3) increase or decrease in appetite or weight; 4) changes in sleep (either insomnia or sleeping too much); 5) changes in the rate of physical activity (moving very slowly or becoming physically agitated and fidgety); 6) feeling tired; 7) feeling worthless or excessively guilty; 8) difficulty concentrating or making decisions; 9) recurrent thoughts of death or suicide (Bieling & Antony, 2003, p. 2). The discovery of half of these symptoms must compel a person to seek professional help.
It is a common belief that certain social factors increase the risk of depression (Melrose, 2011). These social factors are linked to stress and poverty. However, in a study made by Klein and Wender, they concluded that the root cause of depression must not be attributed to social factors alone because they believe that genetics play a much bigger role (2005, p.3). In fact, in one report it says, “there appears to be a fairly strong genetic component in schizophrenia and bipolar disorder” (Alpert & Fava, 2005, p.62). These researchers contend that depression can be passed on from parent to child (Klein & Wender, 2005, p.3). Nevertheless, a negative worldview can increase the risk of developing clinical depression (Beiling & Antony, 2003).
There are also biological factors at play. Consider for instance the discovery that calcium is a necessary ion when it comes to cellular processes (McCance & Huether, 2010). The brain cells “cannot function properly if starved of calcium” (McCance & Huether, 2010, p.16). The deficiency can lead to confusion, hallucination and depression (McCance & Huether, 2010). Based on the aforementioned causes it can be argued that this problem can be treated. But treatment can only be effective if there is a clear distinction between two problem areas such as the need for medication and the need for therapy to counteract both the psychological and emotional issues that has affected the patient’s pattern of thinking.
Gordon’s Health Perception-Health Management Patterns
As conjectured earlier, the proper and timely diagnosis of this particular health problem is extremely difficult because the symptoms are not linked to pathogens and cellular malfunction. As a result there is no evidence of inflammation, no cancerous growth and no skin irritation. Thus, it is important to use a diagnostic tool that can help health professionals monitor and detect health problems at the onset of symptoms. One of the best frameworks that can be used is Gordon’s Functional Health Patterns because it is based on the idea that functional patterns “are influenced by biological, developmental, cultural, social and spiritual factors” (Gordon, 2010, p.2). In my case there are at least two patterns that are applicable and these are: a) Self-Perception – Self-Concept Pattern and b) Coping – Stress-Tolerance Pattern.
Since depression can mask itself in different forms it requires consistent and scientific monitoring to determine if I am also susceptible to this health problem. In the Self-Perception – Self-Concept Pattern there are questions that can help assess problems related to depression. These questions allow the patient to highlight what he feels about himself. These questions guide the patient to uncover the things that made him depressed.
It is imperative to be familiar with this health pattern in order to have mechanism that can monitor mood swings and to pinpoint factors that can lead to depression. In this framework there is also a question that pertains to the negative feeling of losing hope. Thus, there is an automatic device that can lead to the accurate diagnosis of depression. This framework also determines the coping mechanism that can be utilized to mitigate the impact of depression.
The second most important health pattern is the Coping – Stress-Tolerance Pattern that provides another framework that helps the patient to retrace the development of the problem. Even if the root cause of depression is attributed to genetic factors it can be argued that stress can act as a trigger. It is therefore imperative to track down the significant changes in life. This framework also helps to identify any type of medication that could have contributed to the illness.
Future Planning
I have seen the impact of depression in the lives of my relatives. Even teenagers in my family struggle with this disease. For some of my relatives, they have been dealing with this health issue for as long as I can remember. It is difficult to accept that even young adults in my family had to suffer from depression, even before they were given the chance to achieve something worthwhile in this life.
They told me that depression is an awful feeling that seems to be generated by negative thought patterns. They said that it may be a trivial thing to those who are around them but they insisted that the feeling of deep melancholy is as real as the air that they breathe. They desperately wanted to get rid of that awful feeling. It is therefore very helpful to discover that this illness has a genetic origin. It reduces the impact of the social stigma that this health problem brings to the family.
Although the root cause of the problem has a genetic basis, it is important to point out that social factors can be considered as trigger mechanisms. In other words those who are predisposed to this illness may increase the likelihood of developing negative thoughts when faced with an ordeal that they cannot overcome. In some cases poverty can be the culprit, while in others, it can be social pressure or the need to feel safe and secure in a family setting.
It is also practical to determine other factors that tend to mask the real health issue. For example, the use of hypertensive medication can cause misdiagnosis (Doran, 2003). It was discovered by researchers that certain drugs contain an active ingredient called nifedipine, their doctors warned them that this may trigger a side effect (Doran, 2003). As a result a person may already be suffering from depression and yet fail to detect the symptoms because their negative feelings were blamed on the side effect of a particular drug.
I have decided to elucidate on the pathophysiology of depression because I have discovered its prevalence in my family tree. Thus, it is important for me to be armed with the pertinent information regarding this illness to help my loved ones and at the same time to know if I have the predisposition towards this disease. However, there is another reason why I had taken great pains to elaborate on this matter. It is my opinion that depression is a silent killer.
Just like common causes of mortality like heart disease and cancer, depression is as destructive. But oftentimes it is difficult to diagnose. Even when the disease is full blown there is a possibility that the patient has no clear idea as to the kind of problem that he or she is dealing with. It must be made clear that depression can be compared to a blood-sucking leech, ready and able to suck out the life of a person. It is common to see a depressed person devoid of energy and zest for daily living.
Depression reduces the person into a shell of his or her former self. More importantly depression can masquerade itself as deviant behavior, irritability, restlessness, and a deep sense of melancholy that prompted well meaning individuals to prescribe a cure that is non-effective. In other words I would like to help those suffering from this terrible disease. The severity of the problem was clearly propounded by Russel Hampton when he initiated a campaign to increase awareness regarding the medical basis for depression and he wrote:
If there were a physical disease that manifest itself in some particular ugly way… if that disease affected fifteen million people in our country, and further, if there were no help or succor for most of these persons and if they were forced to walk among us in their obvious agony, we would rise up as one social body in sympathy and anger… There isn’t such a physical disease, but there is such a disease of the mind… But we have not risen in anger and sympathy, although they are walking among us in their pain and anguish (Klein & Wender, 2005, p. 3).
It is time to increase awareness regarding the real nature of depression. It is not only a disease triggered by social factors but a health issue that is hereditary in nature. Considering the pathophysiology of depression, it is important to inform people that if they have noticed the prevalence of depression in their family tree then they must be aware that there is a genetic basis for this health problem. Thus, they need not suffer from wrong diagnosis. They need professional help as soon as possible.
References
Alpert, J., & Fava, M. (2005). Handbook of chronic depression: diagnosis and therapeutic management. New York: Marcel Dekker, Inc.
Bieling, P., & Antony, M. (2003). Ending the depression cycle: a step-by-step guide for preventing relapse. CA: New Harbinger Publications, Inc.
Doran, C. (2003). Prescribing mental health medication: the practitioner’s guide. New York: Routledge.
Gordon, M. (2010). Manual of nursing diagnosis. MA: Jones and Bartlett Publishers.
Klein, D., & Wender, P. (2005). Understanding depression: a complete guide to its diagnosis and treatment. New York: Oxford University Press.
McCance, K., & Huether, S. (2010). Pathophysiology: the biologic basis for disease in adults and children. MO: Mosby Elsevier.
McCullough, J. (2003). Treatment for chronic depression: cognitive behavioral analysis system of psychotherapy. New York: The Guilford Press
Melrose, S. (2010). Perfectionism and depression: vulnerabilities nurses need to understand. Nursing Research and Practice, 11, 1-7.